title: Prospective study on the practice of central nervous system prophylaxis and treatment in non-Hodgkin's lymphoma in Spain.
abstract: OBJECTIVE
  Central nervous system (CNS) involvement in patients diagnosed with non-Hodgkin's lymphoma (NHL) or other lymphoproliferative disorders is an infrequent complication with a poor prognosis. The prophylaxis and treatment of CNS involvement in these patients are not homogenous. The aim of this prospective longitudinal study was to report the current practice of CNS prophylaxis and treatment in patients with lymphoproliferative disorders in Spain.
  
  
  METHODS
  Prospective study conducted from June 2005 to June 2006. Adult patients (> or = 18 yr) diagnosed with NHL or other lymphoproliferative disorders who received CNS prophylaxis or treatment were consecutively included through online registration.
  
  
  RESULTS
  228 patients from 33 hospitals were included. The mean (SD) age was 52 (16) yr and 144 (63%) were males. CNS therapy was given to 41 cases and consisted of triple intrathecal (IT) therapy (TIT, methotrexate, cytarabine and hydrocortisone) in 22, liposomal depot cytarabine in 18 and methotrexate in one. In addition, 4 patients received cranial radiotherapy. CNS prophylaxis (n = 187) consisted of TIT (166 cases), IT methotrexate (17), IT liposomal depot cytarabine (3) and IT cytarabine (1), whereas cranial or craniospinal radiotherapy was administered to 2 patients. The main reasons for CNS prophylaxis cited by the investigators included extranodal involvement (89 patients), raised serum lactate dehydrogenase level (87), IPI score > 2 (62), bulky mass (43), extranodal involvement in more than one organ (33), age over 60 yr (28) and human immunodeficiency virus infection (13).
  
  
  CONCLUSIONS
  The results of this study point out the generalized use of TIT therapy both for CNS prophylaxis and therapy in patients with lymphoproliferative disorders in Spain. The introduction of the new formulations of drugs, especially liposomal depot cytarabine for CNS involvement, and the scarce use of radiotherapy are also of note. Similar to other studies, the absence of homogeneous criteria for CNS prophylaxis is of note.
authors.affiliation: Servicio de Hematología Clínica, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain.
authors.forename: Juan-Manuel
authors.initials: JM
authors.lastname: Sancho
authors.forename: Mireia
authors.initials: M
authors.lastname: Morgades
authors.forename: Natalia
authors.initials: N
authors.lastname: Alonso
authors.forename: Guillermo
authors.initials: G
authors.lastname: Deben
authors.forename: Alberto
authors.initials: A
authors.lastname: Fernández de Sevilla
authors.forename: Lourdes
authors.initials: L
authors.lastname: Vázquez
authors.forename: Concepción
authors.initials: C
authors.lastname: Nicolás
authors.forename: José-Antonio
authors.initials: JA
authors.lastname: García Vela
authors.forename: Reyes
authors.initials: R
authors.lastname: Arranz
authors.forename: Eugenia
authors.initials: E
authors.lastname: Abella
authors.forename: Miguel-Angel
authors.initials: MA
authors.lastname: Canales
authors.forename: Pilar
authors.initials: P
authors.lastname: Miralles
authors.forename: Eva
authors.initials: E
authors.lastname: Sánchez
authors.forename: Mar
authors.initials: M
authors.lastname: Hermosilla
authors.forename: Eulogio
authors.initials: E
authors.lastname: Conde
authors.forename: Antonio
authors.initials: A
authors.lastname: Rueda
authors.forename: Josep-Maria
authors.initials: JM
authors.lastname: Ribera
mesh_terms: D016543:Central Nervous System Neoplasms / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000628:therapy*; D008297:Male; D011446:Prospective Studies; D013030:Spain